Insomnia Among Recovered COVID-19 Patients

Background: Insomnia is a sleeping disorder where individuals have difficulty initiating or maintaining sleep, resulting in non refreshing sleep. It may be difficult for patients to fall asleep or remain asleep for the periods recommended for rest. Daytime sleepiness, low energy, irritability, and a depressed mood are usually accompanied by insomnia. Some studies showed that COVID-19 patients could have insomnia during their infection period, and insomnia has been attributed to the stress and depression experienced by the patients during the disease.   Methodology: This is a cross-sectional study that includes 1,215 participants from 15 countries. The inclusion criteria were a recovered patient from COVID-19 with no history of psychological disorders of depression, anxiety, stress, insomnia, or any sleep disorder prior to becoming infected. Athena’s Insomnia Scale was used in the diagnosis of insomnia with a score of ≥ 6.   Results: The insomnia score of the participants was with a mean and standard deviation of 7.04 ± 4.9. Of the 1215 participants, 943 (77.6%) had a score ≥ of 6 representing insomnia, while 272 (22.4%) did not. One-third of the participants visited a doctor because of their sleep quality, and 352 (29%) took medications to help them take enough sleep. Significant differences across patient characteristics were found across countries. Regression analysis found several patient-level aspects predicting insomnia incidence. The odds ratio (OR) symptomatic headache were OR 1.74 (95% CI 1.17, 2.60; P=.006) and OR 1.79 (95% CI 1.19, 2.72; P=.005), for univariate and multivariate regression, respectively. Country and age were also found to be significant  predictors of insomnia incidence in both models.   Conclusion: Insomnia can occur after COVID-19 infection. It is typically mild but has the possibly of requiring treatment and follow-up. People from countries with poor healthcare and the elderly have an increased risk of having insomnia after a COVID-19 infection. The present study investigated the characteristics of those presenting with insomnia after COVID-19 infection in a large sample. We also determined that age, country, and symptomatic headache significantly predict insomnia status.